Provider Demographics
NPI:1164911392
Name:PATHPOINT
Entity Type:Organization
Organization Name:PATHPOINT
Other - Org Name:PHOENIX HOUSE
Other - Org Type:Other Name
Authorized Official - Title/Position:VICE PRESIDENT/DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:
Authorized Official - Last Name:NEWBOLD
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:805-963-1086
Mailing Address - Street 1:315 W HALEY ST STE 102
Mailing Address - Street 2:
Mailing Address - City:SANTA BARBARA
Mailing Address - State:CA
Mailing Address - Zip Code:93101-8052
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:107 E MICHELTORENA ST
Practice Address - Street 2:
Practice Address - City:SANTA BARBARA
Practice Address - State:CA
Practice Address - Zip Code:93101-1905
Practice Address - Country:US
Practice Address - Phone:805-963-1086
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PATHPOINT
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-05-03
Last Update Date:2020-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes320800000XResidential Treatment FacilitiesCommunity Based Residential Treatment Facility, Mental Illness